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A transtheoretical model intervention to help Greek students adopt and maintain a physically active lifestyle

Tzormpatzakis, Nikolaos


Nikolaos Tzormpatzakis


Mike Sleap


Physical activity is positively related to a number of health benefits that influence morbidity and mortality during childhood, adolescence and adulthood. However, an epidemic of physical inactivity is quickly expanding worldwide and particularly affecting the Greek population. Early life periods and especially transitional ones leading to young adulthood are considered critical to intervene to help people adopt and maintain an active lifestyle. Well-designed longitudinal interventions are recommended for these ages.

The main objective of this study was to design, implement and assess an intervention to help students adopt a more active profile according to the Transtheoretical model. This theory was selected due to its practicality and adaptability. The intervention materials consisted of a set of five printed manuals based upon the Transtheoretical model and encouraging physical activity. The study design was quasi-experimental (n=665, mean age=15.8 years, 57% girls) with a stratified assignment of the intervention (nInt=263) and control group (nCon=402). The intervention consisted of the administration of one printed manual to each student according to his/her current stage and its use for the next four months.

Greek secondary students were measured longitudinally in the course of three years extending from two years before their graduation until one year after their graduation. The first two measurements were performed in the second grade of Lyceum (Greek high school) one just before and one just after the intervention. The last two measurements were conducted one year after and two years after the intervention. The research questionnaires measured stages of change, processes of change, decisional balance and self-efficacy, which are the main components of the Transtheoretical model. These instruments assisted firstly with the implementation and secondly with the assessment of the intervention.

The research hypotheses examined the various intervention effects. The main analysis of the stage data was performed with latent transition analysis, which was considered as appropriate and advantageous. The latent stage results revealed positive intervention effects in the short-term, which were neutralised in the mid- and long-term. A comparison of the observed stage data pre- and post-intervention confirmed that in the short-term the intervention had successfully helped more students to progress and fewer students to regress along the stages of change continuum compared to the control group. Regarding self-efficacy, decisional balance and processes of change, within-group longitudinal comparisons of the observed data disclosed positive comparative short-term effects. In general, these effects were also reversed or neutralised in the midterm and remained neutral in the long-term. In most cases the above-mentioned trends of the whole sample were also confirmed for each gender separately making the intervention successful only in the short-term.

Several shortcomings identified in the literature were addressed by the current study by implementing a longitudinal design, conducting a long-term investigation of the intervention effects and specifically adapting and validating the research instruments for the studied population. The “less is more” approach encapsulates the philosophy behind this intervention. In fact, the resources used were kept in a minimum regarding students’ time and schools’ involvement. Together with the easiness of the administration of the intervention contributed to the potential of being easily generalisable to wider populations. Additionally, the development and implementation of the Greek adolescent stages of change manuals was a pioneer work for Greece.

It is recommended that a number of successive interventions be implemented to accomplish a longer duration of positive results. Another recommendation was to expand the public impact of this intervention by attempting it on a larger, even national scale and in different settings. Finally, the positive conclusions of the current study confirmed its success in helping young people adopt and maintain an active lifestyle and also it provided similar future studies with validated tools and added experience to continue in the search for more efficient PA interventions.


Tzormpatzakis, N. (2012). A transtheoretical model intervention to help Greek students adopt and maintain a physically active lifestyle. (Thesis). University of Hull. Retrieved from

Thesis Type Thesis
Publication Date Oct 1, 2012
Deposit Date Oct 2, 2013
Publicly Available Date Feb 23, 2023
Keywords Sport science
Public URL
Additional Information Department of Sport, Health & Exercise Science, The University of Hull


Thesis (4.9 Mb)

Copyright Statement
© 2012 Tzormpatzakis, Nikolaos. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.

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